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Pregnancy, Diabetes, and Your Feet


There are so many changes the body undergoes during pregnancy that it becomes easy to ignore the changes in the feet. During pregnancy the body releases hormones that allow the ligaments to relax in the birth canal. The ligaments in the feet also relax, causing the foot to lengthen and widen. Many will complain of a shoe size increase by one or two sizes. In most circumstances, this flattening and widening of the foot is benign and no problems result.

In the diabetic, this change in foot size is important to recognize. Despite the increase in foot size, many moms will continue to wear the same size shoes. As a diabetic, properly fitting shoes are of utmost importance. Increased pressure on the foot can cause areas of rub or irritation and potentially result in ulceration. Once there is ulceration, one is at risk for infection, delayed healing and further diabetic foot complications.

Diabetic neuropathy is the single greatest risk factor for developing foot ulcerations. Neuropathy is the loss of sensation in the feet commonly caused by diabetes. Many individuals will develop neuropathy before they are diagnosed with diabetes. Others will develop neuropathy years after being diagnosed with diabetes. Luckily, gestational diabetes is not typically associated with neuropathy.

Unfortunately, type I diabetics develop neuropathy much earlier than type II diabetics and may have neuropathy during their pregnancy. Even mild neuropathy increases the risk of ulceration. Wearing shoes which are too small causes an increase in friction and an increased risk of skin breakdown.

Wearing properly fitting shoes during and after pregnancy is of particular importance. Although the ligaments relax in the foot during pregnancy, they do not stay relaxed. The post-pregnancy foot is at higher risk for developing foot problems. There are multiple reasons contributing to the increased risk. The flattened foot places excess stress on the ligament that holds up the arch. The weight gain from pregnancy places excess stress on the feet. Moms are also carrying their baby, added weight which transmits to the feet. To decrease your chances of foot problems during and after pregnancy follow these steps:

1. Check your feet everyday: This is an absolute necessity if you are a type I diabetic or if you have diagnosed neuropathy. Look for cuts, sores, bruises, openings or areas of irritation. Remember, if your nerves are not functioning properly, then you may not feel everything in your feet. If you cannot reach your feet, have a family member check your feet or place a mirror on the floor and put your feet over it.

2. Check your shoes before you put your foot in them.

3. Don't walk around barefoot: Wear a supportive shoe, one that has a rigid sole and bends only where the foot bends (at the toes). If a shoe seems too confined, find a slipper which has a semi-rigid sole, or try a clog or slip-in shoe with a more rigid sole. The remaining aspect of the shoe can be soft and flexible and allow for swelling, but the sole should be rigid from the heel to the ball of the foot.

4. Buy shoes that fit your feet: Be aware of the changes your feet are going through. The feet are most likely widening and lengthening. Make sure the shoes don't cramp the toes. Your feet will not shrink after the birth.

5. Watch out for folds in your socks: A simple fold can cause rub or irritation on your feet. Serious consequences in diabetics can include ulceration and infection.

6. Dry your feet and between toes after showers: Increased moisture between your toes can lead to skin breakdown and eventual ulceration.

7. Don't be a victim of fashion: Most moms will avoid high fashion during pregnancy, but many try squeezing into that strappy heel after. Wearing high heeled shoes puts excess stress on the ball of the foot, cramps the toes and increases the chances of ankle sprains. Tight shoes will increase the chance of ulceration for those with neuropathy.
Check the water by inserting your hand into the water to wrist depth.

8. Don't use a heating pad on your feet: Although the idea of heat on your feet may sound soothing after a long day, the heat will increase swelling and inflammation. Sore feet respond better to ice. Roll your foot over a frozen sports water bottle to help ease the achiness in the arch. The heating pad can cause burns in those who have neuropathy.

9. Don't use any medication on the skin: Be careful of topical medications during pregnancy and during breast-feeding. Don't use medicated corn pads from the local drug stores if you have neuropathy.

Diabetes and Pregnancy is Not Sweet
To bear a child in this world is no doubt one of the most wonderful things that can happen to a woman. But for some women, it is not as simple as carrying a child in your womb and delivering them after nine months. For the longest time, diabetes and pregnancy are two things that didn’t really mix well together. It was used to be discouraged by health workers and doctors due to the complications that may arise from the combination of the two. Thankfully, after years of research and advances in medicine, diabetic women are now given the same chance as any other woman to experience the joys of being a mother.

Women with diabetes now have better chances of having a successful pregnancy. If you are planning to become pregnant, one of the most important things that you must do is to monitor your blood glucose level tightly 3 months before the planned pregnancy and aim for an almost normal level. This is very important so that your body would be prepared for the pregnancy, but most of all, because high blood glucose levels during the first trimester of your pregnancy could cause birth defects in your baby or even miscarriage. It is highly recommended that you consult your doctor way before your planned pregnancy so that he can give you the proper guidelines and program to follow for a successful and safe pregnancy.

Since monitoring your blood glucose level and maintaining it to an acceptable level is of utmost importance, you must put a lot of effort into this. One of the things that you have to do is to develop a special diet that will help you maintain a healthy sugar level. This is usually done with the help of your doctor. Another is to continually self-monitor your sugar level and this should be done 6-8 times a day. Lastly, in order to control your sugar level, use insulin injections instead of oral medications as the effects of oral medications on the baby are still unknown.

Once you’ve become pregnant, it becomes more critical as the baby is now growing inside you. Therefore, the things that you’ve been doing before the pregnancy must still continually be practiced and strictly followed. Ideal gain weight during the pregnancy varies and must be consulted with your doctor, but for a person with a normal weight to start with, 25-35 pounds of gain weight is considered to be ideal.

There are also times that a non-diabetic pregnant woman develops diabetes midway through the pregnancy. This is called gestational diabetes and it happens to 3-5% of pregnant women. Since it occurs midway during pregnancy, birth defects are not as much of a problem as formation of organs occurs during the first 3 months of pregnancy. Still, it could be very dangerous as it could result to the death of the baby. Thus, the precautions done by the women who are diabetic even before the pregnancy must also be strictly implemented in this case especially when it comes to controlling the blood sugar level.

Another complication that may occur during a diabetic pregnancy is having a very large baby. During pregnancy, there’s a lot of interaction happening between the mother and the child. As the mother nourishes the baby, a very high glucose level in the blood received by the baby could cause the baby to become very large. This is due to the inability of the natural insulin in the baby’s body to convert the excess glucose into energy and it becomes converted into fats instead. Thus, you have a very fat baby. This could lead to a more complicated delivery, often needing a cesarean section. After the baby has been delivered, he/she still has to be monitored closely for changes in the blood sugar level.

Women who develop gestational diabetes often lose it after the delivery. However, there are some who retain it and develop type 2 diabetes. Women who developed gestational diabetes must be tested every year for type 2 diabetes as a precautionary measure. Extra large babies also tend to develop obesity and type 2 diabetes later on in their lives. Although this could not be prevented altogether, living a healthy lifestyle and taking precautionary measures can help lower its chances of happening.

In the end, although it’s much more complicated than a normal pregnancy, pregnancy in diabetics now has a good chance of success.


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